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  1. 1

    Why Africa stays poor: and why it doesn't have to - cover story.

    Aronson D

    Humanist. 1993 Mar-Apr; 53(2):[12] p..

    The images are so familiar that we have become all but inured to them: starving African children outlined against a broad expense of empty sky; ragged, impoverished families huddled together on a stony steppe. They could be Biafrans in 1968, Sahelians in 1973, or Ethiopians in 1985. The most recent pictures are from Somalia, a barren stretch of East African coastland that juts into the Indian Ocean. Once a consolation prize in the Cold War (the real trophy in the Horn was Ethiopia, a richer and more populous nation), Somalia has since disintegrated into fiefdoms of grizzled warlords armed with Kalashnikovs and AK-47s. Now 2,000 Somalis die every day from hunger and its attendant diseases, and reports from elsewhere in Africa suggest that Somalia is only the beginning; according to the United Nations, 20 million to 60 million people are at risk of starvation throughout the eastern and southern parts of the continent. (author's)
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  2. 2

    Keeping the promise: 'tangible progress' reported on children's summit goals - special UN round table meeting to observe third anniversary of UN World Summit for Children convenes September 30, 1993 in New York, New York.

    UN Chronicle. 1993 Dec; 30(4):[3] p..

    A special high-level round table on "Keeping the Promise to Children", marking the third anniversary of the historic World Summit for Children, was convened by the UN Secretary-General in New York on 30 September. Attended by eight Heads of State or Government, 14 Foreign Ministers and Special Envoys and other dignitaries, participants discussed how to improve the lot of the world's children by turning the Summit's promises into action. At the Summit, more than 70 Heads of State or Government and 88 high-level delegations from 158 countries adopted a set of goal; for children for the 1990s, contained in the World Declaration on the Survival, Protection and Development of Children, and in the accompanying Plan of Action to implement the World Declaration. (excerpt)
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  3. 3

    In an angry world ... suffer the children - includes related article on UNICEF - United Nations developments.

    UN Chronicle. 1993 Sep; 30(3):[5] p..

    They are the innocent victims of some 40 raging conflicts in the world - approximately 1.5 million children killed, more than 4 million disabled, 5 million in refugee camps and 12 million homeless. A recent United Nations Children's Fund (UNICEF) exhibition, "No War Anymore", held in the public lobby at UN Headquarters in New York, expressed the thoughts in words, as well as in simple drawings, of some of these children who live in terrifying conditions. Children - from Somalia, Cambodia, Mozambique, the former Yugoslavia and other places where war threatens young lives - have touchingly made known their longing for peace. Wrote one child whose words were on exhibit for thousands to see: "Some people say you have to pay a lot for peace. I don't think it costs anything." "Peace", noted another young writer, "is when it is real quiet and you can hear it when there is peace." "Peace is seeing friends again", one child wrote simply. (excerpt)
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  4. 4

    Rapid spread of TB, AIDS discussed by World Health Assembly - includes brief updates on health improvement developments - United Nations developments.

    UN Chronicle. 1993 Sep; 30(3):[3] p..

    The rapid worldwide spread of diseases, such as tuberculosis (TB) and acquired immune deficiency syndrome (AIDS) was a focus of discussions at the forty-sixth World Health Assembly (Geneva, 3-14 May). Plans of the World Health Organization (WHO) to fight health scourges, old and new, were outlined in resolutions adopted by the Assembly. A new Global Strategy for Health and Environment, an outcome of "Agenda 21" - the action programme adopted at the 1992 Earth Summit in Rio de Janeiro - was endorsed. It warned that sustainable development was possible only when special attention was given to health and environment-related matters. WHO was asked to carry out prospective studies on potential environmental hazards to human health. (excerpt)
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  5. 5

    The World Food Programme at 30: fighting hunger, feeding hope - includes statistics - United Nations developments.

    UN Chronicle. 1993 Sep; 30(3):[3] p..

    Truck convoys negotiate narrow roads and hostile, hidden snipers to deliver supplies to besieged enclaves in the mountains of Bosnia and Herzegovina. Roaring C-130 cargo planes unload on a dusty Somalian airstrip, bringing manna from the sky to victims of a cruel famine. The world is familiar with these images on television screens, perhaps less so with the day-to-day work of the World Food Programme (WFP) of the UN, which helps bring food into those and other hot-spots of human suffering. Since 1963, WFP has grown from a small experimental programme to the world's largest donator and distributor of food, aiming both to bring quick relief to disaster-areas and foster long-term development and self-sufficiency. On the occasion of WFP's thirtieth anniversary, the UN Chronicle spoke with Executive Director Catherine Ann Bertini. Is the role of WFP different now from its original mandate 30 years ago? Yes, it has changed. When we began operations in 1963, our mandate was to combat hunger and promote economic and social development. The developmental portfolio has expanded and we have assisted about 1,600 projects around the world. The Programme had less than $100 million to spend in its first year, but today WFP's annual budget is around $1.7 billion and our services reach 42 million people. (excerpt)
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  6. 6

    Draft declarations against violence approved by Commission - United Nations Commission on the Status of Women - includes related article on the rights of married women.

    UN Chronicle. 1993 Jun; 30(2):[4] p..

    A draft declaration on the elimination of violence against women was unanimously approved by the Commission on the Status of Women at its thirty-seventh session (17-26 March, Vienna). It was among 13 resolutions approved by the 45-member Commission on issues ranging from women's role in development to preparations for the 1995 World Conference on Women. The non-binding declaration, which is to be submitted to the forty-eighth General Assembly for adoption later this year, states that violence against women is an obstacle to the achievement of equality, development and peace--the three main goals of the UN to advance the status of women. It contains a comprehensive definition of violence against women and identifies the responsibilities of States and organizations in applying remedial measures. That definition includes physical and psychological violence within the family, marital rape and female genital mutilation, as well as sexual harassment and intimidation at work and in schools. States are called on not to "invoke any custom, tradition or religious or other consideration" to avoid their obligations to implement the declaration. (excerpt)
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  7. 7

    Global plan on child labour adopted - Human Rights - includes related article on the rights of children.

    UN Chronicle. 1993 Jun; 30(2):[7] p..

    Adoption of a Programme of Action for the Elimination of the Exploitation of Child Labour was a highlight of the forty-ninth session of the Commission on Human Rights (1 February-12 March, G The new 39-paragraph global plan of action calls for special attention for the most vulnerable categories of children--street children and children of immigrants, refugees minorities or indigenous groups. Formulated by the Subcommission on Prevention of Discrimination and Protection of Minorities--a subsidiary body of the Commission--the document calls for increased bilateral and multilateral resources to address "one of the prime causes of exploitation of child labour, which is poverty". In adopting 114 texts--98 resolutions and 16 decisions--the 53-member body continued its work towards monitoring the implementation of the 1948 Universal Declaration of Human Rights and other important international instruments dealing with civil, political, economic, social and cultural rights. (excerpt)
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  8. 8

    The right to development: a North-South divide? - World Conference on Human Rights.

    UN Chronicle. 1993 Mar; 30(1):[5] p..

    The growing economic divide between North and South may well be reflected in the upcoming World Conference on Human Rights, as many developing and industrialized countries define their human rights concerns in sharply different terms. One basic difference over how much emphasis to place on the "right to development" may set the tone for a pointed debate at the Vienna conference. Many developing countries contend that political and civil rights cannot be separated from or be given priority over economic, social and cultural rights. Increasingly, they have asserted that development is an essential human right and objected to what many see as the industrial countries' narrow view of human rights as solely involving political and civil liberties. Indeed, in their view, economic development and an adequate living standard are preconditions of expanded political and civil rights. Further, the "collective rights" of people, some argue, may take precedence over certain rights of individuals. (excerpt)
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  9. 9

    The age-old dream: freedom, justice, dignity for all - World Conference on Human Rights.

    UN Chronicle. 1993 Mar; 30(1):[5] p..

    Forty-four years ago, the UN adopted the Universal Declaration of Human Rights, a comprehensive document eloquently sketching the inalienable rights with which all of us are born. Since then, the UN has slowly and methodically agreed on a body of human rights covenants, protocols and declarations, further defining our collective economic, social, cultural, political and civil rights and creating a system to protect them. While few dispute the enormous progress made in spelling out these rights, it is tragically apparent that human rights continue to be violated everywhere, often on a massive scale. This contradiction lies at the heart of the decision by the General Assembly to convene the World Conference on Human Rights, to be held in Vienna from 14 to 25 June 1993. The World Conference will review the progress made since the first global conference was held in Teheran, Iran in 1968. It is to explore the possibilities for further refining the five main categories of human rights, and seek ways to improve and strengthen existing systems for promoting and protecting human rights at the international, regional and national levels. A primary Conference goal will be to make protection of human rights an integral component of social and economic development worldwide. (excerpt)
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  10. 10
    Peer Reviewed

    Domestic violence as a human rights issue. [La violencia doméstica como un problema de derechos humanos]

    Thomas DQ; Beasley ME

    Human Rights Quarterly. 1993 Feb; 15(1):36-62.

    Part I of this paper examines why domestic violence was not analyzed traditionally as a human rights issue. It discusses the three independent, though interrelated, changes that occurred to begin to make such an analysis possible: the expansion of the application of state responsibility; the recognition of domestic violence as widespread and largely unprocesuted (brought about by greater public and international recognition of the daily violence experienced by women); and, the understanding that the systematic, discriminatory non-prosecution of domestic violence constitutes a violation of the right to equal protection under international law. Part II describes the first practical application of this evolving approach, in Brazil, where the presence of a broad-based women's movement made it possible to collect the data necessary to support an analysis of the government's responsibility for domestic violence. Finally, Part III explores the value and limitations of the human rights approach to combating domestic violence. We conclude that the human rights approach can be a powerful tool to combat domestic violence, but that there are currently both practical and methodological limitations--in part related to the use of the equal protection framework to assign state responsibility for domestic violence--that are problematic and require further analysis to make the approach more effective. (excerpt)
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  11. 11

    [Marginalized urban and rural areas in Latin America] reas rurales y urbanas marginadas de América Latina.

    Elu MC

    In: Simposio Latinoamericano de Planificación Familiar, Noviembre - Diciembre, 1992, México D.F., México, edited by Guillermina Herrera. Mexico City, Mexico, Population Council, 1993 Nov. 22-25.

    Latin America, with its almost 460 million inhabitants, constitutes a heterogeneous reality made up of diverse and contrasting levels of development and sociopolitical situations. It consists of 20 countries-the Spanish-speaking countries of the continent and the Caribbean, plus Brazil-that in one way or another saw their economies seriously affected beginning in the early 1980s. Multiple factors contributed to that situation, most significant among them the drop in prices of their raw materials on the international market and the increase in their onerous external debts. It was no surprise that the Economic Commission for Latin America and the Caribbean (ECLAC) characterized the 1980s as the economically "lost decade." (excerpt)
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  12. 12

    [Women's initiatives] Las iniciativas de las mujeres.

    Kapur N

    In: Enfoques feministas de las políticas antiviolencia, [compiled by] Centro de Encuentros Cultura y Mujer [CECYM]. Buenos Aires, Argentina, CECYM, [1993]. 75-79. (Travesías: Temas del Debate Feminista Contemporáneo 1)

    I will make another comment on views in the first world of women from the third world. I sometimes believe that the perspectives are very simplistic. From a first world standpoint, it is very easy to say: "we will talk about development and violence, and we will help women from all types of countries who don't have or know anything better." It's not that simple, where you can merely state that a country "is backward as regards women, because it is a backward nation." Backward in the sense that this is a nation whose population is not sufficiently well educated. This is a simplistic notion that contributes to perpetuating many of the feelings of indulgence on the part of aid agencies in diverse donor countries, which encounter a large dose of skepticism and cynicism in the countries receiving that help. In these countries people want to know why they want to help us, what they want to know about our countries to use to their advantage. Then I think that it is necessary to keep in mind that you cannot have a simple notion about complex social problems and a complicated cultural situation about which you know nothing. (excerpt)
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  13. 13

    Breastfeeding counselling: a training course. Trainer's guide, part one. Sessions 1-9.

    World Health Organization [WHO]. Programme for Control of Diarrhoeal Diseases; UNICEF

    Geneva, Switzerland, WHO, Programme for Control of Diarrhoeal Diseases, 1993. [379] p. (WHO/CDR/93.4; UNICEF/NUT/93.2)

    The International Code of Marketing of Breastmilk Substitutes has been in place for more than a decade, and much effort to protect breastfeeding from commercial influences has followed. One requirement for being "Baby Friendly" is that a facility shall not accept or distribute free samples of infant formula. However, even mothers who initiate breastfeeding satisfactorily, often start complementary feeds or stop breastfeeding within a few weeks of delivery. All health workers who care for women and children after the perinatal period have a key role to play in sustaining breastfeeding. Many health workers cannot fulfill this role effectively because they have not been trained to do so. Little time is assigned to breastfeeding counselling and support skills in the preservice curricula of either doctors, nurses or midwives. Hence there is an urgent need to train all health workers who care for mothers and young children, in all countries, in the skills needed to both support and protect breastfeeding. The purpose of "Breastfeeding counselling: A training course" is to help to fill this gap. The materials are designed to make it possible for trainers with limited experience of teaching the subject to conduct up-to-date and effective courses. The concept of `counselling' is new, and the word can be difficult to translate. Some languages use the same word as `advising'. However, counselling means more than simple advising. Often, when you advise people, you tell them what you think they should do. When you counsel a mother, you help her to decide what is best for her, and you help her to develop confidence. You listen to her, and to try to understand how she feels. This course aims to give health workers listening and confidence building skills, so that they can help mothers more effectively. (excerpt)
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  14. 14

    Clinical study of sexual transmission of hepatitis B.

    Zang JH

    Journal of Chinese Sexology. 1993 Mar; (1):26-27.

    It is widely known that viral hepatitis is transmitted through intestinal tract infection or blood infection. However, it has not aroused much attention that the disease can be transmitted through sexual behavior. WHO has listed this disease as one of sexually transmitted diseases. Blocking the infectious link of sexual behavior is an essential tool in preventing and curing hepatitis B. This article intends to detect signs of Hepatitis B through vaginal secretion of 51 pregnant and postnatal women of childbearing age and to discuss the relationship between sexual behavior of people with Hepatitis B and clinical infection. Discussion: In China, the positive rate of surface antigen in pregnant and postnatal women is 2% to 7%, depending on the region. 1. It is 6.5% in Shenyang, lower than that in men. Pregnant and postnatal women who are surface antigen negative and who exhibit Hepatitis B symptoms people account for 22% of all surface antigen-negative people. 2. According to statistics, this study holds that 100% vaginal secretions of people with indication of Hepatitis B carry the Hepatitis B virus, and 6.6% (1/6) is strongly infectious. This indicates that chances of vaginal secretions of average women of childbearing age carrying Hepatitis B virus are high. The link between sexual behavior and the transmission of the Hepatitis B virus must be cut. (excerpt)
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  15. 15

    Recent development of perinatal medicine in China.

    Yan RY

    Chung-Hua Fu Chan Ko Tsa Chih / Chinese Journal of Obstetrics and Gynecology. 1993 Aug; 28(8):457-459.

    Perinatal medicine is a new branch of medicine related to pregnancies that has developed during the past 30 years in the world. It was first introduced to China at the end of the 1970s. In 1981, the Society of Obstetrics and Gynecology of the Chinese Medical Association organized the first academic meeting on perinatal science in China. With the help of the World Health Organization, China invited experts in this field to hold seminars in China, training key personnel from various provinces, cities and autonomous regions, who then spread the knowledge all over the country. The development of perinatal medicine in China has been characterized by the following. (excerpt)
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  16. 16

    [Lessons learned concerning water, health and sanitation. Thirteen years of experience in developing countries. Updated edition. Lecciones aprendidas en materia de agua, salud y saneamiento. Trece anos de experiencia en países en desarrollo. Edicion actualizada.

    Camp Dresser and McKee International. Water and Sanitation for Health [WASH]

    Arlington, Virginia, WASH, 1993. [175] p. (USAID Contract No. 5973-Z-00-8081-00)

    As this latest edition of "Lessons Learned" informs us, sustainable development in the water and sanitation sector is not just the construction of an installation or the installation of a hand pump, but the way in which these interventions help people improve their quality of life. More importantly, we see that sustainable development promotes change: change in the way in which power is distributed and technologies are spread. The issue of participation is explored in this report through an analysis of associations of donors, governments, non-governmental organizations, and private for-profit companies. The notion of the association imposes certain responsibilities on the beneficiary governments and their communities. (excerpt)
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  17. 17

    Law, ethics and human rights: statement of belief.

    United Nations Development Programme [UNDP]. HIV and Development Programme

    [New York, New York], UNDP, HIV and Development Programme, 1993. [1] p.

    We believe that every individual has a right to dignity, health and life. Public health and the interests of the community in the context of the HIV epidemic depend upon respect for individual rights and recognition of the worth of each member of our society. We acknowledge that we are all likely to be affected by the HIV epidemic. We believe that the law must promote an environment that enables, encourages and sustains voluntary behavior change and the care and support of those affected. This requires the empowerment of individuals and communities to protect themselves against HIV, and that people living with HIV remain integrated within society and free from all forms of discrimination. We affirm that it is the responsibility of each individual, community and nation to make up this cause through existing means of advocacy and by creating new ones. We must express and act upon a concern for ourselves and others. We recognize that the subordinate position of women within their families and communities makes them particularly susceptible to HIV infection. Social structures, laws and practices, as well as values and attitudes, must change to improve the status of women. We believe that the development of effective responses to the HIV epidemic requires, above all, the active participation of people affected by the epidemic, as well as the building of partnerships amongst communities, governments and the legal, health and other professions. (excerpt)
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  18. 18

    Istanbul Declaration.

    International Congress on Population Education and Development (1993: Istanbul)

    In: First International Congress on Population Education and Development, Istanbul, Turkey, 14-17 April, 1993. Action Framework for Population Education on the Eve of the Twenty-First Century. Istanbul declaration, [compiled by] United Nations Population Fund [UNFPA] [and] UNESCO. [New York, New York], UNFPA, 1993. 5-7.

    Participants at the International Congress on Population Education and Development, organized by the United Nations Educational, Scientific, and Cultural Organization (UNESCO) and the UN Populations Fund in Istanbul during April 14-17, 1993, adopted the Istanbul Declaration and approved an action framework for population education. Population is one of the world's most serious concerns, which education can help to solve. The world's population needs to be taught about important population issues. In particular, population education projects and programs need to reach to all levels of the educational system, to all types of educational institutions, and to all settings of non-formal education. Population education should be developed as an integrated component of educational curricula. Population education, environmental education, and international education all improve the quality of life and the relationships of humans with each other and nature. Congress participants call upon international and organizational support for new and ongoing population education.
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  19. 19

    Objectives and priorities of the Eighth Plan.

    Nepal. National Planning Commission

    In: The International Conference on Population and Development, September 5-13, 1994, Cairo, Egypt. Nepal's country report, [compiled by] Nepal. National Planning Commission. Kathamandu, Nepal, National Planning Commission, 1993 Sep. 40-9 p.

    This document contains the first appendix to Nepal's report to the 1994 International Conference on Population and Development. The appendix lists the objectives and priorities of Nepal's Eighth Development Plan (1992-97) as achieving sustainable economic growth, poverty alleviation, and reduction of regional imbalances. The next section discusses the major policies of the plan that relate to: 1) population policy (reducing the fertility rate from 5.8 to 4.5; increasing life expectancy; reducing infant, child, and maternal mortality; and managing internal migration); 2) poverty alleviation (for the 49% of the population affected); 3) manpower and employment (creating jobs); 4) health (improving general health, extending health services to rural areas, extending maternal-child health services and family planning programs, and developing specialized health services); 5) urban development; 6) environmental protection and resource conservation; 7) child development; 8) food and nutrition; and 9) women in development (promoting the equal and meaningful participation of women in development, in policy-making, and in traditional and nontraditional sectors).
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  20. 20

    Report and recommendations of the Informal Technical Working Group Meeting on STD Activities in IDS, Geneva, 17-19 June 1992.

    Informal Technical Working Group Meeting on STD Activities in IDS (1992: Geneva)

    [Unpublished], 1993. Background paper for Informal Technical Working Group Meeting on STD Activities in GPA, Geneva, Switzerland, February 15-17, 1993. 9, [5] p.

    The June 17-19, 1992, meeting of the Informal Working Group was held to review the progress achieved to date on STD activities in IDS; to review, revise, and further develop materials and protocols; to discuss criteria for, and selection of, study sites; and to review proposals and to make recommendations on studies. This report presents the main areas of discussion and recommendations. Clinical management is discussed in the following subsections: algorithms for the diagnosis and case-management of persons with urethritis and genital ulcer disease, symptomatic women, asymptomatic women at presumed low risk of STD, and asymptomatic women at high risk of STD. Education and counseling within STD settings are then discussed in terms of partner notification in the primary health care setting and the integration of STD services in maternal-child health and family planning. Closing consideration is given to targeted STD service interventions and STD interventions within national programs.
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  21. 21

    [Female genital mutilation in France] Mutilations sexuelles feminines en France.

    Mouvement Francais pour le Planning Familial [MFPF]. Centre de Documentation

    Paris, France, MFPF, 1993 Jun. ii, 73 p. (Dossier Documentaire)

    The French Movement for Family Planning (MFPF) has compiled documents on female genital mutilation in France. The documents are presented with an introduction entitled Excision in Law and four sections addressing the last excision trials in France; action of the public powers; in the UK, family planning action and of IPPF; trials for excision in January and February 1993 (facts across the press); and family planning in Mali fighting against sexual mutilation. Interspersed in these sections are witness accounts, indictments, and counsel's speech. Some titles of newspaper and magazine articles in the MFPF collection include Five Years in Prison for Excision (Le Monde); For the First Time in France, an African is Condemned to a Year on a Prison Farm for Having Her Daughters Excised (Le Monde); Excision: The Pain of the Innocents (Nouvel Observateur); and Excision: The Word of Cut Women (Marie-Claire). The MFPF collection presents an IPPF report called Restoring to Women their Life Space which is about female genital mutilation. The collection ends with an interview in the Bulletin of the Malian Association for Family Planning (AMPPF) with an obstetrician-gynecologist serving on the AMPPF executive board who addresses excision and other traditional practices.
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  22. 22

    Oxygen therapy for acute respiratory infections in young children in developing countries.

    World Health Organization [WHO]. Programme for the Control of Acute Respiratory Infections

    [Unpublished] 1993. ii, 49 p. (WHO/ARI/93.28)

    The World Health Organization's (WHO) Programme for the Control of Acute Respiratory Infections (ARIs) reviewed the literature to provide this background paper on oxygen therapy for ARIs in young children in developing countries. The paper begins with a review of the use of oxygen therapy and examines its role in reducing pneumonia-related mortality and indications for its use. The review discusses the strength of the evidence for a relationship between individual clinical signs and hypoxemia or mortality associated with severe pneumonia. The clinical signs discussed include central cyanosis, inability to drink, severe chest indrawing, breath rate of more than 70 breaths per minute in children aged 2 months to 5 years, grunting in infants aged less than 2 months, and restlessness. The second major section of the paper is devoted to the oxygen delivery system. Oxygen cylinders and oxygen concentrators are sources of oxygen. Methods of oxygen administration covered include nasopharyngeal catheter, nasal prongs (cannula), headbox, facemask, and humidification. The third major section provides guidelines for oxygen administration. More specifically, it covers indications for oxygen use when oxygen is scarce and when it is abundant and for when to stop oxygen therapy, warnings on the use of oxygen, using oxygen concentrators and oxygen cylinders (especially installation, equipment for the administrator of oxygen, and initial procedures), giving oxygen to more than one patient from a concentrator and from a cylinder, and administration of oxygen through various methods.
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  23. 23

    Bronchodilators and other medications for the treatment of wheeze-associated illnesses in young children.

    World Health Organization [WHO]. Programme for the Control of Acute Respiratory Infections

    [Unpublished] 1993. [2], [iv], 37 p. (WHO/ARI/93.29)

    The World Health Organization's (WHO) Programme for the Control of Acute Respiratory Infections (ARIs) reviewed the literature to provide this background paper on available drugs for the treatment of wheeze, the common causes of wheeze, and the pathogenesis and pathophysiology of asthma and bronchiolitis. It focuses on children in countries with a high infant mortality rate and where bacterial pneumonia is a major public health problem. When health providers manage wheeze in children, they must consider the fact that bacterial pneumonia is the leading cause of respiratory death in young children in developing countries. Even health providers in developed countries should consider bacterial pneumonia as the cause of wheeze. These providers tend to associate viral infections with wheeze. Many children with an ARI have combined viral and bacterial infections. About 50% of outpatient cases with confirmed Haemophilus influenzae and Streptococcus pneumoniae bacteremic pneumonia have wheeze. The first bronchodilator physicians should use to manage acute episodes of wheeze is a beta-2 adrenergic agent, e.g., salbutamol. Financial limitations will restrain the likelihood of long-term preventive therapy of acute episodes of wheeze caused by asthma. The best prophylactic options for asthma-related recurrent wheeze are sodium cromoglycate and inhaled corticosteroids. The leading therapeutic drugs for treating acute asthma include an inhaled beta-2 adrenergic agent with oral corticosteroids if needed. This treatment will achieve bronchodilatation and reversal of the airway narrowing caused by mucosal edema, by mucus hypersecretion, and by smooth muscle spasm. Long-term beta agonist therapy alone will not reduce airway inflammation. Allergen avoidance can also protect against recurrent wheeze in some cases. The annexes include tables on the presentation and dosage of bronchodilators and other drugs for the treatment of wheeze in children aged 0-5 and on bronchodilators and other drugs for the treatment of wheeze in the WHO list of essential drugs.
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  24. 24

    How to investigate drug use in health facilities. Selected drug use indicators.

    World Health Organization [WHO]. Action Programme on Essential Drugs

    Geneva, Switzerland, WHO, Action Programme on Essential Drugs, 1993. ii, 87 p. (WHO/DAP/93.1; DAP Research Series No. 7)

    The WHO Action Program on Essential Drugs has developed and field tested a core set of drug use indicators capable of describing drug use patterns and prescribing behaviors in a country, region, or individual health facility. These indicators can be used to measure the impact of interventions designed to change prescribing practices, detect performance problems, and compare the performance of providers and institutions. Three categories have been developed: 1) prescribing indicators--average number of drugs per encounter, percentage of drugs prescribed by generic name, percentage of encounters with antibiotic prescribed, percentage of encounters with injection prescribed, and percentage of drugs prescribed from essential drugs list or formulary; 2) patient care indicators--average consultation time, average dispensing time, percentage of drugs actually dispensed, percentage of drugs adequately labelled, and patients' knowledge of correct dosage; and 3) facility indicators--availability of copy of essential drugs list or formulary and availability of key drugs. All data required to measure the core indicators can be derived from medical records or direct observation. Field testing in developing countries such as Nigeria and Tanzania found these measures both feasible to obtain and informative as first-level indicators. Also presented are descriptions of key issues related to study design and sampling, field methods, analysis, and follow up.
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  25. 25

    Implementation of the global malaria control strategy. Report of a WHO Study Group on the Implementation of the Global Plan of Action for Malaria Control, 1993-2000.

    World Health Organization [WHO]. Study Group on the Implementation of the Global Plan of Action for Malaria Control


    A World Health Organization (WHO) Study Group recommends how to best implement the Global Malaria Control Strategy, first at the regional level, then at the national level. It provides a plan for program managers, health service administrators, and international partners in health development to determine priorities for the development and management of malaria control that address local situations and needs. The Work Group proposes ways to strengthen general health services to allow them to be completely responsible in making early diagnosis and providing treatment for people at risk. Its report provides guidance on how communities can become involved as full partners in malaria control efforts. It sets standards for developing epidemiological and managerial information systems that meet local and global needs for monitoring the malaria situation and for program planning, monitoring, and evaluation. The report's section on disease management covers diagnosis and treatment of malaria, training and health education for malaria management, drug supply and logistics, and quality assurance. In the disease prevention section, it discusses options and criteria for use of selective vector control, identification of epidemiological types, and implementation of preventive measures. The section on health information systems addresses information needs at the periphery, generation of information by general health services, reorientation of information towards disease management, malaria case definition, information requirements for evaluation and monitoring, mechanisms for monitoring, mechanisms for monitoring epidemic risk, and strengthening operational research capabilities.
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